Provider Demographics
NPI:1013392240
Name:COASTAL CARE SERVICES, INC
Entity Type:Organization
Organization Name:COASTAL CARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP
Authorized Official - Prefix:MR
Authorized Official - First Name:YSEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-481-0505
Mailing Address - Street 1:1200 NW 78TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33126-1816
Mailing Address - Country:US
Mailing Address - Phone:855-481-0505
Mailing Address - Fax:
Practice Address - Street 1:1200 NW 78TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33126-1816
Practice Address - Country:US
Practice Address - Phone:855-481-0505
Practice Address - Fax:855-481-0606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-29
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management